Health Insurance Claims Processing | Data Entry Microsoft Expert
Metro Manila
Detail-oriented Manual QA Tester and Healthcare Insurance Specialist with 5+ years of experience in the healthcare and health insurance industry. I combine hands-on expertise in manual and functional software testing with strong knowledge of health insurance, medical claims processing, and healthcare billing. My expertise includes: • Manual and functional testing of healthcare and insurance systems • Health insurance claims processing and validation • Analyzing business and system requirements and converting them into detailed test cases and test plans • Understanding and reviewing CPT, ICD-10, HCPCS, and other medical billing codes • Validating claims based on procedure codes, diagnosis codes, billing information, and business rules • Researching and identifying appropriate codes and requirements for claims processing • Reviewing claim data for accuracy, completeness, and compliance • Performing data validation and testing expected vs. actual results • Working with healthcare business rules, policies, and client requirements • Following SOPs, quality standards, and compliance guidelines • Collaborating with business analysts, developers, and other teams to resolve issues. My background in healthcare claims processing gives me an advantage when testing healthcare applications because I understand not only how the system should function, but also the business and medical billing logic behind the transactions. 1 am highly detail-orient, analytical, and committed to delivering curate, reliable with a high quality results. Highly detail-oriented professional with experience in data entry, data validation, document management, and administrative support. Proficient in Microsoft Excel, Word, and Outlook, with strong attention to accuracy, organization, and meeting deadlines. Experienced in handling large volumes of data while maintaining quality and confidentiality.
Accenture, full_time
Sep 2017 to Feb 2021